Lactylation, a newly identified post-translational modification of lactate metabolism, has been implicated in degenerative diseases. However, its roles in intervertebral disc degeneration (IVDD) remain unexplored. This study aimed to identify database- and literature-derived lactylation-associated candidate hub genes (abbreviated as “lactylation-associated candidate hub genes”) in IVDD, characterize their biological functions, and validate potential targeted therapeutic compounds. Differential expression analysis of the GSE56081 dataset identified 3305 differentially expressed genes (DEGs). Weighted gene co-expression network analysis (WGCNA) screened IVDD-associated key module genes, which were intersected with 327 known lactylation-associated candidate hub proteins to obtain 42 overlapping genes. Protein–protein interaction (PPI) network analysis (STRING/Cytoscape) identified hub genes, followed by GO/KEGG enrichment, immune infiltration (CIBERSORT), molecular docking, and in vitro validation (CCK-8, LDH, RT-qPCR). Five core lactylation-associated candidate hub genes (RBM39, HNRNPU, SFPQ, HNRNPL, DDX5) may potentially regulate IVDD progression through involvement in RNA metabolism, ferroptosis, HIF-1 signaling, and immune microenvironment remodeling (increased CD8+ T cells, Th17 cells, Tregs, macrophages, neutrophils; decreased monocytes, B cells), though direct mechanistic evidence is still needed. Curcumin exhibited strong binding affinity with hub proteins, especially SFPQ (− 7.8 kcal/mol) and regulated their expression in nucleus pulposus cells, maintaining cell viability and reducing cytotoxicity. This study is the first to systematically identify lactylation-associated candidate hub genes that are potentially involved in IVDD pathogenesis via multiple pathways and immune microenvironment modulation. Curcumin shows favorable binding potential with these hub proteins and may serve as a candidate targeted therapeutic agent for IVDD. Our findings provide novel insights into the molecular mechanisms of IVDD and a preliminary basis for guiding the development of lactylation-related precision treatment strategies.

Methyltransferase-like 3 (METTL3) plays a role in the development of knee osteoarthritis (KOA). However, the mechanism underlying the role of METTL3 in KOA is unclear. This work investigated the effects of MELLT3 on ferroptosis and pain relief in in vitro and in vivo KOA models. Chondrocytes were treated with 10 ng/mL interleukin-1β (IL-1β) or 5 μM Erastin (ferroptosis inducer). IL-1β or Erastin treatment inhibited cell viability and glutathione levels; increased Fe2+, lipid reactive oxygen species and malondialdehyde production; and decreased glutathione peroxidase 4, ferritin light chain and solute carrier family 7 member 11 levels. The overexpression of METTL3 facilitated the N6-methyladenosine methylation of high mobility group box 1 (HMGB1). HMGB1 overexpression reversed the effect of sh-METTL3 on IL-1β-treated chondrocytes. A KOA rat model was established by the injection of monosodium iodoacetate into the joints and successful model establishment was confirmed by haematoxylin and eosin staining and Safranin O/Fast Green staining. METTL3 depletion alleviated cartilage damage, the inflammatory response, ferroptosis and knee pain in KOA model rats, and these effects were reversed by the addition of HMGB1. In conclusion, METTL3 depletion inhibited ferroptosis and the inflammatory response, and ameliorated cartilage damage and knee pain during KOA progression by regulating HMGB1.

Background Zhiqiao Gancao decoction (ZQGCD) was created by Professor Gong Zhengfeng, a renowned Chinese medicine expert. Clinical studies have shown its efficacy in alleviating pain and enhancing lumbar function in intervertebral disc degeneration (IDD) patients. However, the precise mechanism of ZQGCD in treating IDD remains unclear. Methods The active components of ZQGCD were identified using Liquid chromatography-tandem mass spectrometry (LC-MS/MS). A rat model of intervertebral disc degeneration was established, and rats in each group received ZQGCD for three weeks. Assessment parameters included hyperalgesia status, observation of intervertebral disc tissue degeneration and macrophage infiltration, and analysis of JAK2/STAT3 pathway protein expression in the intervertebral disc. Primary macrophage M1 polarization was induced using LPS, with cells treated using the JAK2 inhibitor (AZD1480) and ZQGCD to evaluate macrophage polarization, cellular supernatant inflammatory factors, and JAK2/STAT3 pathway expression. Macrophage supernatant served as a conditioned medium to observe its effects on the proliferation of nucleus pulposus cells (NPCs) and the expression of collagen II and MMP3 proteins. Results A total of 81 active components were identified in ZQGCD. Following ZQGCD treatment, infiltrating macrophages in intervertebral disc tissues of model rats decreased, the content of M1 macrophages decreased, while the content of M2 macrophages increased, the expression of proinflammatory factors and pain-inducing factors in serum decreased, and the expression of substance P in intervertebral disc tissue decreased. Consequently, the intervertebral disc degeneration and hyperalgesia of rats were improved. In vitro studies revealed that LPS induced M1 macrophage polarization. By inhibiting the JAK2/STAT3 pathway, both JAK2 inhibitors and ZQGCD effectively suppressed M1 polarization, resulting in decreased levels of IL-1β, IL-6, TNF-α, and various other inflammatory factors. Consequently, this inhibition led to a delay in the degeneration of NPCs. Conclusion There is macrophage infiltration in the intervertebral disc tissue of IDD rats, and JAK2/STAT3 pathway is activated, macrophages are polarized to M1 type, resulting in inflammatory microenvironment, leading to intervertebral disc degeneration and hyperalgesia. ZQGCD exhibited a delaying effect on IDD and improved hyperalgesia by inhibiting the JAK2/STAT3/ macrophage M1 polarization pathway.

In the context of the development of intervertebral disc degeneration (IDD), inflammatory mediators play a pivotal role. Nevertheless, due to the influence of the inflammatory microenvironment, the causal relationship between specific inflammatory mediators and the development of IDD remains uncertain. The understanding of the causal relationship between inflammatory mediators and IDD is of great importance in preventing and delaying disc degeneration in the future. We utilized genetic data concerning systemic circulating inflammatory regulators obtained from a Genome-Wide Association Study (GWAS) analyzing 41 serum cytokines in a cohort of 8293 individuals from Finland. The genetic data for IDD were derived from the most recent GWAS summary statistics conducted within the FinnGen consortium, encompassing 37,636 IDD cases and 270,964 controls. Our analysis employed bidirectional 2-sample Mendelian randomization (MR) techniques, which included several MR methods such as MR Egger, weighted median, inverse variance weighted, weighted mode, and simple mode. Additionally, the MR-PRESSO method was employed to identify horizontal pleiotropy, heterogeneity was quantified using the Cochran Q statistic, and MR-Egger intercept analysis was performed to assess pleiotropy. We established causal relationships between 3 specific inflammatory factors and IDD. Elevated levels of MIP-1 beta (OR = 0.956, 95% CI: -0.08 to -0.006; P = .02) and IFN-G (OR = 0.915, 95% CI: -0.16 to -0.02; P = .01) expression were associated with a reduced risk of IDD. Conversely, genetic susceptibility to IDD was linked to a decrease in IL-13 levels (OR = 0.967, 95% CI: -0.063 to -0.004; P = .03). In this study, we have identified inflammatory factors that exhibit a causal relationship with the onset and progression of IDD, as supported by genetic predictions.

Background Inflammation and immune factors are the core of intervertebral disc degeneration (IDD), but the immune environment and epigenetic regulation process of IDD remain unclear. This study aims to identify immune-related diagnostic candidate genes for IDD, and search for potential pathogenesis and therapeutic targets for IDD. Methods Gene expression datasets were obtained from the Gene Expression Omnibus (GEO). Differential expression immune genes (Imm-DEGs) were identified through weighted gene correlation network analysis (WGCNA) and linear models for microarray data analysis (Limma). LASSO algorithm was used to identify feature genes related to IDD, which were compared with core node genes in PPI network to obtain hub genes. Based on the coefficients of hub genes, a risk model was constructed, and the diagnostic value of hub genes was further evaluated through receiver operating characteristic (ROC) analysis. Xcell, an immunocyte analysis tool, was used to estimate the infiltration of immune cells. Finally, nucleus pulposus cells were co-cultured with macrophages to create an M1 macrophage immune inflammatory environment, and the changes of hub genes were verified. Results Combined with the results of WGCNA and Limma gene differential analysis, a total of 30 Imm-DEGs were identified. Imm-DEGs enriched in multiple pathways related to immunity and inflammation. LASSO algorithm identified 10 feature genes from Imm-DEGs that significantly affected IDD, and after comparison with core node genes in the PPI network of Imm-DEGs, 6 hub genes (NR1H3, SORT1, PTGDS, AGT, IRF1, TGFB2) were determined. Results of ROC curves and external dataset validation showed that the risk model constructed with the 6 hub genes had high diagnostic value for IDD. Immunocyte infiltration analysis showed the presence of various dysregulated immune cells in the degenerative nucleus pulposus tissue. In vitro experimental results showed that the gene expression of NR1H3, SORT1, PTGDS, IRF1, and TGFB2 in nucleus pulposus cells in the immune inflammatory environment was up-regulated, but the change of AGT was not significant. Conclusions The hub genes NR1H3, SORT1, PTGDS, IRF1, and TGFB2 can be used as immunorelated biomarkers for IDD, and may be potential targets for immune regulation therapy for IDD.

目的:系统评价中国人群腰椎间盘突出症(lumbar disc herniation,LDH)的患病率.方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献服务系统、Web of Science、PubMed、Embase和Cochrane Library中关于中国人群LDH患病率的横断面研究文献,检索时限均为2000 年1 月1 日至2022 年8 月30 日.2 名研究人员独立进行文献筛选、数据提取和质量评价.采用Stata15.0 软件进行数据统计分析.结果:共检索到1449 篇文献,通过逐层筛选最终纳入26 篇文献,Meta分析结果显示中国人群LDH患病率为6%[95%CI(0.05,0.06)].基于不同纳入文献的亚组分析结果显示,中国男性和女性LDH的患病率均为4%[95%CI(0.02,0.05),95%CI(0.02,0.05)];中国26～40 岁人群LDH的患病率为 3%[95%CI(-0.01,0.09)],41～60 岁人群LDH的患病率为8%[95%CI(-0.01,0.17)],60 岁以上人群LDH的患病率为11%[95%CI(0.07,0.15)];中国人群 2006-2010 年LDH的患病率为2%[95%CI(0.01,0.02)],2011-2015 年LDH的患病率为 3%[95%CI(0.01,0.06)],2016-2021 年LDH的患病率为12%[95%CI(0.04,0.20)];中国农村居民LDH的患病率为 3%[95%CI(0.02,0.03)],城市居民LDH的患病率为8%[95%CI(0.04,0.12)];中国南方人群LDH的患病率为5%[95%CI(0.04,0.06)],北方人群LDH患病率为6%[95%CI(0.04,0.07)].结论:中国人群LDH的患病率为6%,且中国人群LDH的患病率随年龄增长和年代推移呈上升趋势,城市居民LDH的患病率高于农村居民,北方人群LDH的患病率高于南方人群.

Purpose: The aim of this study was to investigate the effect of Zhiqiao Gancao decoction (ZQGCD) on hyperalgesia in lumbar disc herniation (LDH) and its mechanism. Methods: The potential mechanism of ZQGCD's therapeutic effect on LDH was investigated through network pharmacology, which involved screening the targets of eight components that were absorbed into the bloodstream. The effects of CCR2 inhibitors and ZQGCD-containing serum on the excitability of the CCL2/CCR2 signaling pathway and dorsal root ganglion neurons (DRGn) were investigated in vitro. The effects of CCR2 inhibitors and ZQGCD on the expression of the CCL2/CCR2 signaling pathway and ASIC3 in the rat intervertebral disc and dorsal root ganglion (DRG), the degree of disc degeneration, the threshold of foot retreat, and the latency of foot retreat in LDH rats were examined in vivo. The binding affinities and interaction modes between CCR2 and the components absorbed into the blood were analyzed using the AutodockVina 1.2.2 software. Results: Network pharmacology revealed that ZQGCD could treat LDH through a mechanism involving the chemokine signaling pathway. It was observed that the CCR2 inhibitor and ZQGCD-containing serum downregulated CCR2 and ASIC3 expression and decreased cell excitability in DRGn. The CCL2/CCR2 signaling pathway was activated in the degenerated intervertebral disc and DRG of LDH rats, increased the expression of ASIC3, and decreased the mechanical allodynia domain and thermal hyperalgesia domain. However, a CCR2 inhibitor or ZQGCD could ameliorate the above changes in LDH rats. The target proteins, CCL2 and CCR2, exhibited a robust affinity for the eight components that were absorbed into the bloodstream. Conclusion: The CCL2/CCR2 pathway was activated in the intervertebral disc and DRG of LDH rats. This was accompanied by upregulation of ASIC3 expression, increased excitability of DRGn, and the occurrence of hyperalgesia. ZQGCD improves hyper-algesia in LDH rats by inhibiting the CCL2/CCR2 pathway and downregulating ASIC3 expression.

目的:系统评价中药复方治疗退行性腰椎管狭窄症(DLSS)的临床疗效及安全性.方法:计算机检索中国知网(CNKI)、万方数据(WANFANG DATA)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(SinoMed)、Pubmed、Web of science、Embase等数据库中有关中药复方治疗腰椎管狭窄症的临床随机对照试验(RCTs),检索时间从建库至2020年8月31日.根据Jadad评分对纳入文献进行质量评价,采用Review Manager 5.3分析软件对结局指标进行Meta分析.结果:纳入12篇RCTs,共1222例患者.Meta分析结果显示,治疗组在总有效率(RR=1.23,95％CI[1.16,1.30],P＜0.00001)、视觉模拟评分法(VAS)评分(MD=-1.88,95％CI[-2.51,-1.25],P＜0.00001)、日本骨科协会评估治疗分数(JOA)评分(MD=5.30,95％CI[3.46,7.13],P＜0.00001)、Oswestry 功能障碍指数(ODI)评分(MD=-8.88,95％CI[-17.06,-0.70],P=0.03)、全血高切黏度(MD=-0.76,95％CI[-1.09,-0.43],P＜0.00001)、全血低切黏度(MD=-1.45,95％CI[-2.29,-0.61],P=0.0007)、纤维蛋白原(MD)=-5.79,95％CI[-7.50,-4.07],P＜0.00001)、肿瘤坏死因子-α(TNF-α)(MD=-0.48,95％CI[-0.53,-0.44],P＜0.00001)、C-反应蛋白(CRP)(MD=-8.30,95％CI[-9.79,-6.81],P＜0.00001)方面均优于对照组,差异有统计学意义.在不良反应发生率方面,2组差异无统计学意义(RR=0.34,95％CI[0.06,1.89],P=0.22).结论:中药复方治疗PLSS疗效显著,且安全性较高.

The inflammatory radicular pain induced by lumbar disc herniation (LDH) is a serious problem worldwide. Demethoxycurcumin (DMC) is a yellow pigment derived from turmeric. Although it is considered a safe natural compound for managing inflammation-associated diseases, but the molecular mechanisms of LDH remain to be elucidated. In the current study, DMC reduced the production of IL-1β, IL-4, and IL-6 in nucleus pulposus (NP) cells subjected to TNF-α-induced inflammation. Moreover, the inhibitory mechanism was activated upon suppression of activation of MAPKs and NF-κB signalling in NP cells. Further experiments with LDH model rats supported the in vitro results. These studies expand our knowledge of the effect of DMC on LDH; DMC may be a viable alternative to the drugs used to treat LDH.

目的 使用Meta分析的方法评价中药复方治疗椎间盘源性腰痛的有效性.方法 检索PubMed、中国知网、维普科技期刊数据库、万方数据库、Cochrane,根据Cochrane的标准,由2名研究者独立评估数据资料,纳入相关要素,并使用Review Manerger5.4对纳入研究行Meta分析.结果 严格按照纳排标准,最终纳入24项随机对照试验,共2 104例椎间盘源性腰痛患者(试验组1 054例、对照组1 050例).Meta分析结果示:中药治疗在总有效率[RR=1.24,95％CI(1.18,1.31)]、4周及末次视觉模拟量表(VAS)评分[MD=-1.28,95％CI(-1.65,-0.90),P＜0.00001;MD=-1.46,95％CI(-1.75,-1.18),P＜0.00001)]、4 周及末次 Oswestry 功能障碍指数(ODI)评分[MD=-6.89,95％CI(-9.87,-3.91),P＜0.00001;MD=-5.50,95％CI(-6.05,-4.96),P＜0.00001)]及日本骨科协会评估治疗量表(JOA)评分[(MD=4.15,95％CI(2.69,5.61),P＜0.00001)]等方面,均优于对照组.结论 单纯中药复方口服或联合其他疗法,均在缓解患者腰痛、改善腰椎功能以及提高生活质量方面有较为明显的优势,但仍需通过大样本量、高质量的随机对照试验进一步验证.

Parameters mismatching between the real optical system and phase retrieval model undermines wavefront reconstruction accuracy. The three-dimensional intensity position is corrected in phase retrieval, which is traditionally separated from lateral position correction and axial position correction. In this paper, we propose a three-dimensional intensity position correction method for phase diverse phase retrieval with the cross-iteration nonlinear optimization strategy. The intensity position is optimized via the coarse optimization method at first, then the intensity position is cross-optimized in the iterative wavefront reconstruction process with the exact optimization method. The analytic gradients about the three-dimensional intensity position are derived. The cross-iteration optimization strategy avoids the interference between the incomplete position correction and wavefront reconstruction during the iterative process. The accuracy and robustness of the proposed method are verified both numerically and experimentally. The proposed method achieves robust and accurate intensity position correction and wavefront reconstruction, which is available for wavefront measurement and phase imaging.

Bone is the most common late metastasis of breast cancer. Bone metastasis causes not only severe bone pain, but also bone-related diseases such as pathological fractures, which are closely related to osteoclasts. The effects of demethoxycurcumin (DMC) on osteoclast biology has not been investigated. In this study, we explored the effects of DMC on MDA-MB-231 cells, MCF-7 cells, and osteoclasts induced by RANKL in vitro, as well as the protective effect on bone destruction of tumor bone metastasis in vivo. DMC showed inhibitory effect on the migration and promotes the apoptosis of MDA-MB-231 and MCF-7 cells. At the same time, DMC inhibited osteoclast maturation and mature osteoclast bone resorption in a dose-dependent manner, and suppressed the expression of osteoclast marker genes TRAP, CTSK, MMP9, V-ATPase-d2 and DC-STAMP significantly. Biochemical data showed that DMC inhibited tumor cells and osteoclasts by inhibiting the early activation of ERK and JNK MAPK pathway. Consistent with the results in vitro, we confirmed that DMC protects bone destruction caused by tumor metastasis in vivo. In short, our study confirmed that DMC could be used as a potential drug for the treatment of tumor bone destruction.

目的:观察龚氏四步复位法术前复位对旋后外旋型Ⅳ度踝关节骨折围手术期疗效的影响.方法:2018年1月至2020年1月期间完成治疗的旋后外旋型Ⅳ度踝关节骨折患者30例,予以龚氏四步复位法复位、石膏固定、手术治疗,分析患者围手术期患肢疼痛VAS评分、术后踝关节功能AOFAS评分、张力性水泡、切口皮缘坏死渗液等并发症情况.结果:本组患者的术前等待时间为(3.03±1.23)d,手术时间为(78.67±26.93)min.VAS评分入院时为(6.97±1.13)分,复位后为(4.67±1.39)分;术前1d为(3.41±1.13)分,术后3d为(3.17±1.02)分,术后14 d为(1.67±0.61)分.术后3个月时AOFAS评分为(57.00±5.28)分,术后6个月评分为(77.37±5.92分),术后12个月为(85.53±4.85)分.切口并发症方面,仅发生张力性水泡2例(发生率6.7％),无切口皮缘坏死及渗液病例,切口均工/甲愈合.结论:术前及时采用龚氏四步复位法手法复位,能较快减轻旋后外旋型Ⅳ度踝关节骨折患者术前疼痛,使患者具备较好的软组织条件及骨折对位条件,缩短术前等待时间,便于手术操作,术后踝关节功能持续恢复,并发症发生率低.

The treatment of bone defects caused by various reasons is still a major problem in orthopedic clinical work. Many studies on osteogenic implant materials have used various biologically active factors such as osteogenic inducers, but these biologically active factors have various side effects. Therefore, in this study, silk fibroin (SF) was used as a scaffold material, mesoporous bioactive glass nanoparticles (MBGNs) as a sustained release carrier, and the traditional Chinese drug icariin (ICA) was loaded to promote bone formation. The experiments in this study have proven that SF/MBGNs-ICA scaffolds can successfully load and release ICA for a long time, and the sustained-release ICA can promote the proliferation and differentiation of BMSCs for a long time. This controlled-release ICA organic/inorganic two-component scaffold material is expected to become a new bone grafting solution.

As a computational imaging method, phase retrieval has wide applications in image reconstruction, wavefront detection, image encryption, etc. It is an image-based wavefront sensing technique and compared with some other traditional measurement methods such as interferometry, phase retrieval has the advantages of easy operation, high accuracy and strong adaptability to the environment. Conventional phase retrieval algorithms, such as the Gerchberg–Saxton (GS) algorithm, retrieve wavefront by iterative calculation. But limited by finite information of the captured diffractive light filed, the calculation process is easy to fall into local minimum value and stagnation occurs in practical, making it unable to converge to the right wavefront. In this paper, in order to improve this phenomenon, a phase retrieval method combined with the zone plate is proposed in this paper. In this method, zone plates are added into the traditional iterative phase retrieval algorithm to modulate the incident wavefront and combined with the multi-focus property, it can collect more effective information about the wavefront in a single optical intensity distribution image and realize a better wavefront reconstruction result. Simulation results indicate that by taking zone plates into calculation, more effective reconstruction results can be acquired. On the one hand, the recovery residual is smaller compared with conventional lens. On the other, although all of these methods reach to a stagnation, zone-plate-based methods are more efficient to get a better result.

目的:回顾分析吴门骨伤桡骨远端骨折手法整复联合马粪纸夹板固定治疗老年C型桡骨远端骨折的临床疗效.方法:选取2018年10月至2019年5月接受治疗的45例老年C型桡骨远端骨折患者,按照AO分型系统中C型骨折C1,C2,C3分为A,B,C三组.三组均使用吴门骨伤桡骨远端骨折四步复位法整复并用马粪纸夹板进行稳定固定,定期随访复查腕关节正侧位X线片并调整扎带松紧度,采用统计学方法分析比较三组患者临床疗效、腕关节Green-O'Brien评分(疼痛程度、功能恢复、活动范围、握力等四个方面)及影像学测量指标(掌倾角、尺偏角及桡骨高度).结果:治疗6个月后A组患者腕关节Green-O'Brien评分及影像学指标均显著优于B和C组,差异有统计学意义(P＜0.05);A组临床疗效优良率为75.00％,高于B组的46.67％及C组的30.00％,差异有统计学意义(P＜0.05).结论:对于老年C型桡骨远端骨折,手法皆可获得良好的复位,但固定不一定适合每一型.联合马粪纸夹板固定比较适用于C1型老年桡骨远端骨折,可较好促进腕关节恢复,而对于C2和C3型则效果一般.

The aliasing effect in the discrete Fourier transform inherent will impose a serious detrimental effect on conventional phase retrieval measurement accuracy with under-sampled intensity. In this Letter, we describe a modal-based nonlinear optimization phase retrieval approach that is capable of retrieving wavefront measurements using under-sampled intensities. The extended Nijboer-Zernike theory is introduced to establish an analytic solution between wavefront phase and intensity image, and then nonlinear optimization is further utilized to solve wavefront aberration coefficients from under-sampled intensity data. The feasibility and accuracy of the algorithm are verified by simulations and experiments. This is a promising method that is especially suitable for full field phase recovery of optical systems with a relatively high numerical aperture.

目的 探讨靶点技术在经皮脊柱内镜治疗腰椎间盘突出症中的临床疗效.方法 128例腰椎间盘突出症患者运用靶点技术行经皮脊柱内镜下髓核摘除术,采用VAS腰痛和腿痛评分、Oswestry功能障碍指数(ODI)、椎间盘突出体积变化以及改良MacNab标准进行评价.结果 术后72 h、3个月、6个月VAS腿痛评分均较术前减轻(P＜0.05);与术前相比,术后72 h时VAS腰痛评分略有下降(P＞0.05),但至术后3个月时才有改善(P＜0.05).术后72 h、3个月、6个月直腿抬高度数较术前均有改善(P＜0.05);健侧直腿抬高术后3个月也较术前有所改善(P＜0.05).术后72h、3个月、6个月ODI均较术前减少(P＜0.05).椎间盘突出体积由术前的(1376.4±438.7)mm3下降到术后的(488.3±191.4)mm3(P＜0.05).术后6个月,根据MacNab标准对总体疗效进行评价:优43例,良76例,中6例,差3例,优良率达93.0％.结论 在经皮脊柱内镜治疗腰椎间盘突出症中运用靶点技术具有手术时间短、住院时间短等优势,还能有效清除致压物,缓解患者腰腿痛,提高生活质量,临床疗效显著.

OBJECTIVE To investigate the technique, mechanism and clinical efficacy of manual reduction of WU medical school in the treatment of anterior glenohumeral dislocations. METHODS From January 2016 to December 2017, 181 patients with anterior glenohumeral dislocations were treated with our manual reduction, including 71 males and 110 females, ranging in age from 19 to 94 years old, with a mean age of(61.1±16.3) years old; 68 cases of subglenoid type, 93 cases of subcoracoid type and 20 cases of subclavian type. Constant score was used to evaluate limb function while the external fixation was removed. RESULTS One hundred and fifty-seven patients achieved reduction at the first attempt and 23 patients achieved at the second time. There was no vascular damage, nerve damage or iatrogenic fracture accmpanied. The Constant score ranged from 75 to 100, with a mean score of 92.1±4.3. One hundred and sixty-eight patients were followed up, and the duration ranged from 12 to 24 months, with an average of (16.1±3.2) months, no recurrent dislocation occurred during the follow up period. CONCLUSIONS The manual reduction of WU medical school in the treatment of anterior glenohumeral dislocations has high success rate and low complication rate, which is scientific, safe, standardized, easy to learn and worth promoting.

OBJECTIVE:To compare the clinical effects between open reduction internal fixation and three-dimensional reduction with external fixation under analgesia in treating fresh thoracolumbar fractures, and explore the simple and effective method for thoracolumbar fractures. METHODS:The clinical data of 40 patients with thoracolumbar fractures who met the inclusion and exclusion criteria in the department of orthopaedics affiliated to Suzhou Hospital of Nanjing University of Chinese Medicine from February 2013 to August 2017 were retrospectively analyzed. According to therapeutic methods, the patients were devided into treatment group and control group, 20 cases in each group. Treatment group was treated by three-dimensional reduction method and external fixation devices under analgesia, and control group was treated by open reduction and common spinal fixation system. In treatment group, there were 9 males and 11 females, aged from 26 to 68 years old with an average of (52.8±11.3) years; and in control group, there were 10 males and 10 females, aged from 26 to 64 years old with an average of(50.6±8.8) years. Anterior vertebral body compression(AVBC), Cobb angle and visual analogue scale(VAS) were measured and compared in two group. RESULTS:All 40 patients finished follow-up. The follow-up time in treatment group was 5 to 37 months with average of (16.1±8.8) months, in control group was 5 to 29 months with an average of(17.3±6.0) months. There was no significant difference between two groups(P>0.05). AVBC, Cobb angle, VAS score were obviously improved in all patients after treatment(P<0.05), but there were no significant difference between two groups(P>0.05). CONCLUSIONS:Clinical effect of two methods was similar in treating thoracolumbar fractures, but three-dimensional reduction and external fixation devices under analgesia has advantage of easy operation, smaller trauma and no need secondary surgery for removed internal fixation.